Effects of Nested Interruptions on Task Resumption: A Laboratory Study With Intensive Care Nurses

Sasangohar, Farzan; Donmez, Birsen; Easty, Anthony C.; Trbovich, Patricia

doi:10.1177/0018720816689513

Cited by 23 publications

(14 citation statements)

References 28 publications

(42 reference statements)

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“…Our approach to classify events solely into one category does not take full account of potential multiple meanings and inherent implications of interruptive communication, for example, a nurse alert concerning the arrival of a time-critical patient does often imply subsequent coordination demands 3. Our interruption measure did not account for the assessment of serial or nested interruptions,48 task complexities, behavioural strategies to deal with disruptions6 or interruption priorities. Altogether, this limits causal inferences concerning potential harm of disruptive events during ED care 10 12 14…”

Section: Discussionmentioning

confidence: 99%

Provider interruptions and patient perceptions of care: an observational study in the emergency department

2018

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BackgroundInterruptions are endemic in healthcare work environments. Yet, they can have positive effects in some instances and negative in others, with their net effect on quality of care still poorly understood. We aimed to distinguish beneficial and detrimental forms of interruptions of emergency department (ED) providers using patients’ perceptions of ED care as a quality measure.MethodsAn observational design was established. The study setting was an interdisciplinary ED of an academic tertiary referral hospital. Frequencies of interruption sources and contents were identified in systematic expert observations of ED physicians and nurses. Concurrently, patients rated overall quality of care, ED organisation, patient information and waiting times using a standardised survey. Associations were assessed with hierarchical linear models controlling for daily ED workload. Regression results were adjusted for multiple testing. Additionally, analyses were computed for ED physicians and nurses, separately.ResultsOn 40 days, 160 expert observation sessions were conducted. 1418 patients were surveyed. Frequent interruptions initiated by patients were associated with higher overall quality of care and ED organisation. Interruptions relating to coordination activities were associated with improved ratings of ED waiting times. However, interruptions containing information on previous cases were associated with inferior ratings of ED organisation. Specifically for nurses, overall interruptions were associated with superior patient reports of waiting time.ConclusionsProvider interruptions were differentially associated with patient perceptions of care. Whereas coordination-related and patient-initiated interruptions were beneficial to patient-perceived efficiency of ED operations, interruptions due to case-irrelevant communication were related to inferior patient ratings of ED organisation. The design of resilient healthcare systems requires a thorough consideration of beneficial and harmful effects of interruptions on providers’ workflows and patient safety.

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Section: Discussionmentioning

confidence: 99%

Provider interruptions and patient perceptions of care: an observational study in the emergency department

2018

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“…2,15 It is noted that requests for help, both by the patient and by the nurse, as well as the clarification of doubts, are possible when there is interruption. 11,17,19 As to the negative aspects, 11 studies have found that interruptions favor the occurrence of errors, both in care and in the preparation or administration of medications. 6,10,19,21, It is evidenced that the interruption impairs the safety of the patient, a result similar to that found in a DISCUSSION J Nurs UFPE on line.…”

Section: Level IVmentioning

confidence: 99%

Interrupções no trabalho do enfermeiro e na segurança do paciente

Paiva

Oliveira²,

Silva

et al. 2019

Rev enferm UFPE on line.

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Objetivo: identificar os efeitos das interrupções na rotina de trabalho do enfermeiro e na segurança do paciente. Método: trata-se de estudo bibliográfico, descritivo, tipo revisão integrativa de literatura, com a coleta de dados nas bases de dados MEDLINE, CINAHL, Web of Science e LILACS, em artigos indexados de 2013 a 2017, analisando-os de forma descritva, após a apresentação em figuras. Resultados: encontraram-se 17 artigos e se percebeu que revelaram aspectos negativos em relação à interrupção na rotina de trabalho do enfermeiro e na segurança do paciente e 76,5% mostraram, também, pontos positivos. Salienta-se que os resultados analisados não apoiaram consistentemente a relação negativa entre as interrupções e as suas implicações na rotina de trabalho do enfermeiro e na segurança do paciente. Conclusão: evidenciaram-se aspectos que favorecem a ocorrência de interrupções na prática do enfermeiro, entretanto, há poucos estudos que descrevem o impacto das interrupções na prática e na segurança do paciente. Faz-se necessária uma ampla compreensão dos fatores que ocasionam as interrupções e colocam em risco a segurança do paciente. Descritores: Enfermagem; Segurança do Paciente; Interrupção; Fluxo de Trabalho; Cuidados de Enfermagem; Gerenciamento do Tempo.ABSTRACTObjective: to identify the effects of disruptions on the nurse's work routine and patient safety. Method: this is a bibliographical, descriptive, type-integrative review of literature, with the collection of data in the MEDLINE, CINAHL, Web of Science and LILACS databases, in indexed articles from 2013 to 2017, analyzing them in a descriptive way, after the presentation in figures. Results: 17 articles were found and it was noticed that they revealed negative aspects regarding interruption in the nurse's work routine and patient safety, and 76.5% also showed positive points. It should be noted that the results analyzed did not consistently support the negative relationship between the interruptions and their implications in the nurse's work routine and patient safety. Conclusion: aspects that favor the occurrence of interruptions in nurses' practice were evidenced, however, there are few studies that describe the impact of interruptions on the practice and safety of the patient. There is a need for a broad understanding of the factors that cause disruption and jeopardize patient safety. Descriptors: Nursing; Patient Safety; Interruption; Workflow; Nursing Care; Time Management.RESUMENObjetivo: identificar los efectos de las interrupciones en la rutina de trabajo del enfermero y en la seguridad del paciente. Método: se trata de un estudio bibliográfico, descriptivo, tipo revisión integradora de literatura, con la recolección de datos en las bases de datos MEDLINE, CINAHL, Web of Science y LILACS, en artículos indexados de 2013 a 2017, analizándolos de manera descriptiva, después de la presentación en figuras. Resultados: se encontraron 17 artículos y se observó que revelaron aspectos negativos relacionados con la interrupción en la rutina de trabajo del enfermero y en la seguridad del paciente, y el 76.5% mostraron también puntos positivos. Cabe señalar que los resultados analizados no apoyaron de manera consistente la relación negativa entre las interrupciones y sus implicaciones en la rutina de trabajo del enfermero y en la seguridad del paciente. Conclusión: se evidenciaron aspectos que favorecen la ocurrencia de interrupciones en la práctica del enfermero, sin embargo, existen pocos estudios que describan el impacto de las interrupciones en la práctica y en la seguridad del paciente. Se hace necesaria una amplia comprensión de los factores que causan las interrupciones y ponen en riesgo la seguridad del paciente. Descriptores: Enfermería; Seguridad del Paciente; Interrupción; Flujo de Trabajo; Atención de Enfermería; Administración del Tiempo.

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“…In the anatomy of an interruption, at least two tasks (Sasangohar, Donmez, Easty, & Trbovich, 2017) are typically involved: the origin (primary) task and the interrupting (secondary) task (Boehm-Davis & Remington, 2009). An interruption begins with the interrupting task, in the middle of the origin task.…”

Section: Defining Interruptionsmentioning

confidence: 99%

Human-Agent Interruptions: A Systems Perspective

Salehi

Chiou

2017

Proceedings of the Human Factors and Ergonomics Society Annual

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Detrimental effects of interruptions have been widely reported in the literature, particularly with laboratory-based studies. However, recent field-based studies suggest interruptions can be beneficial, even vital to maintaining or enhancing system performance. The literature seems to be at critical juncture; how do practitioners reconcile these perspectives? Do we ban interruptions or let them flow freely? To address this, we study how interruptions affect work performance over differing units of analysis (a dyad versus an individual) in a microworld scheduling task with 72 participants and a computer agent. We found that a team performance perspective shows more benefits from interruptions than an individual performance perspective. In other words, teams suffered less from the adverse effects of interruptions than individuals. Results show that systems-level aspects of interruptions, for both the individual and the team, plays a role in determining whether interruptions have a positive or negative effect.

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Effects of Nested Interruptions on Task Resumption: A Laboratory Study With Intensive Care Nurses

Abstract: The nested nature of interruptions adds to the resumption lag and diminishes resumption accuracy by likely populating the working memory with goals associated with interrupted secondary tasks.

Cited by 23 publications

References 28 publications

Provider interruptions and patient perceptions of care: an observational study in the emergency department

Provider interruptions and patient perceptions of care: an observational study in the emergency department

Interrupções no trabalho do enfermeiro e na segurança do paciente

Human-Agent Interruptions: A Systems Perspective

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